But there are instances in which the predisposition evidently developed in sleep is obscure and difficult to understand. Thus cholera in all its forms, sporadic, spasmodic, bilious, and malignant, invades most frequently in the night, towards morning, after sleep has lasted some time. Colic awakes the patient often. Diarrhea and dysentery begin when the night's sleep is about to end. The relations of sleep to fever are curious. In thirty years of inquiry, I have heard of very few instances, not more than six in all, of the supervention of intermittent, the occurrence of a chill, in the state of sleep. Malarious remittent seldom or never, I know no example, attacks during sleep. On the contrary, yellow fever often arouses the startled slumberer. Among the phlegmasiæ, croup, laryngitis, often come upon the sleeping subject. Sleep, quiet and profound, is, in a very large proportion of diseases, not only a good symptom, but positively and beyond question remedial. It suspends many irritative, and some inflammatory affections. Catarrhal annoyances yield, for the time, to its gentle sway; it is the only hope of relief in numerous forms of agonizing cephalalgia. Neuralgic anguish of every kind is not only suspended while it continues, but, when regularly recurrent, has its tenacious periodicity interrupted most efficiently. Indeed, in almost all periodical affections, some advantage is sure to be derived from the use of narcotics, so timed as to put the patient soundly to sleep at, or a little before, the hour of their return. This is remarkably notable in the instance of malarious intermittents, which I have many scores of times put off by a soporific dose of opium. Indeed, I think most of the therapeutic benefits of opium, ascribed to its diaphoretic property, flow from its delightful influence in procuring sleep, a state almost incompatible with certain modes of irritation and inflammation; and this leads me to hope much similar advantage from the enlarging list of anæsthetics, in all forms of disease of which the combination of these elements constitutes the prominent feature of the first or invading stage. The want of sleep, morbid vigilance, aggravates almost all diseases, and may give rise to many. Dr. Brigham, than whom there cannot be named higher authority on this point, believes it to be paramount among the causes of insanity. In fevers, generally, it does great harm by the protracted cerebral erethism of which it is both cause and consequence. Of its relation to delirium tremens, I have already spoken. The moral influences of sleeplessness are worth noting. The temper becomes harsh and sour; the man is petulant, testy, unreasonable, and liable to great depression of spirits. Ultimately, both mind and body succumb. The most savage animals are tamed by this privation; and experiments show that horses and men break down more under the fatigue of night-work and night-marching than under the greatest exposure and hardest labor during the hours of sunshine. Dr. Willshire gives a case of hysteric sleeplessness of fourteen days' duration, with only eleven hours sleep in all that time; Dr. G. Bird an instance in which an hysterical lady was kept awake by mental emotion for five days; and Dr. J. Johnson one of a gentleman going to the West Indies, who had "no sleep for several weeks." Yet we are told that none of these subjects suffered permanent injury. Sleep-my most grateful and worthy theme, would that my pen or tongue were equal to its celebration!—has been grossly libelled by poets and philosophers, as in some measure allied to death. The highest poetical authority uses the phrase "Death's twin brother, Sleep!" Bichat affirms that death is but a collection of partial sleeps of the various organs and functions. J. M. Good defines sleep "as the death or torpitude of the voluntary organs, while the involuntary continue their accustomed actions. Death is the sleep or torpitude of the whole." I protest against these views as full of gross error. Death and sleep differ toto colo; the former is the beginning of disintegration-the latter the chief or only means of renovation. Death implies destructive change; sleep restorative change. Death is the correlative and opposite of life, organic activity; sleep is the correlative and opposite of sensuousness, psychical activity. The mistake results, in part, from a confusion between inactivity and inaction. From the moment when sleep commences, the activity or capacity of action begins to be renewed, and goes on increasing, but is totally lost when the living frame has fallen into the torpitude of death. The English Henry expresses his grief at having "frighted" sleep; but the approach of sleep seems to have frighted Sir Thomas More, who would never trust himself with "Nature's soft nurse," on account of the alleged family likeness, without a prayer to heaven for protection. I do not mean to blame the good knight; a prayer is never misplaced. Montaigne, too, the quaint old Gaul, remarks that "it is not without reason that we dwell on the resemblance between death and sleep;" and then exclaims, "How carelessly we pass from waking to sleep! with how little anxiety do we lose the consciousness of light and of ourselves. The faculty of sleep might even seem useless and contrary to nature as depriving us of all feeling and action, but that it serves to instruct us that we are made to die as well as to live, and to accustom us to go out of life without fear." The same idea seems to have been in the mind of the English poet when he exclaimed: "Oh! what a wonder seems the fear of death- The ancient phrase, Mors janua vita, is true in the sense of a glorious promise for the future. Sleep is always the gate of life, and every waking may be fancifully termed a resurrection. Happy if our faith were strong enough to remove all anxiety, as Montaigne suggests, in the one case as in the other. But the analogy fails. Instinct makes for us, unerringly, the wide distinction which reason and science have failed to draw; we all delight to sleep, we all fear to die. Doubt and gloom prevail, and we sigh with the poet minstrel, "Ah! when will day dawn on the night of the grave!" Our Divine Teacher dwelt on the contrast strongly, when he said of his friend Lazarus, "He is not dead, but sleepeth ;" and of Jairus' daughter, "The maiden is not dead, but sleepeth." It is a beautiful expression in the Hebrew Lyric, "He giveth his beloved sleep!" And what greater boon can be offered by the good Father to his weary, care-worn, suffering child? Every sorrow is soothed, every pain assuaged, every grief hushed for a time, and even the anguish of guilt and of remorse awhile suspended. To sleep is, in most diseases, to take a step at least towards recovery. It is in our best health a necessary preparation for the active duties of life, whether physical, moral, or intellectual. The strength is restored, the temper improved by tranquil slumber, and the judgment rendered clearer and more impartial. "Oh, sacred rest, Sweet pleasing sleep! of all the powers the best; Care shuns thy soft approach, and sullen flies away!" |